Aims

The study aimed to evaluate the effects of foot-ankle flexibility and resistance exercises on the recurrence rate of plantar foot diabetic ulcers, HbA1c levels, diabetic neuropathy examination (DNE) scores, ankle brachial index (ABI), and walking speed within 12 and 24 weeks.

Methods

We conducted a double-blind randomized clinical trial. Fifty patients with recently healed plantar foot diabetic ulcers were randomized to an intervention group that performed foot-ankle flexibility and resistance exercise three times a week in their home (n = 25) or a control group (n = 25). Both groups were given foot care education. Outcomes were assessed at plantar foot diabetic ulcer recurrence or at 12 and 24 weeks whichever came first. Outcome measures included plantar foot diabetic ulcer recurrence, changes of HbA1c levels, DNE scores, ankle brachial index ABI, and walking speed.

Results

There were significant difference between groups in ulcer recurrence at either 12 weeks (intervention 8%, control 68%, RR 0.288; 95% CI 0.156–0.534, P = 0.000) within 12 weeks.

or 24 weeks (intervention 16%, control 72%, RR 0.222; 95% CI 0.088–0.564, P = 0.000).). There were significant differences in the DNE score delta (P = 0.000) and walking speed delta (P = 0.000), but there were no significant differences in the HbA1c delta and ABI delta between groups at either 12 or 24 weeks.

Conclusions

Foot-ankle flexibility and resistance exercises can reduce the recurrence of plantar foot diabetic ulcer incidence and improve diabetic neuropathy and walking speed.

Clinical trial number: NCT04624516

中文翻译：

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足踝柔韧性和抗阻运动在足底糖尿病溃疡二级预防中的作用

目标

该研究旨在评估足踝柔韧性和抗阻运动对足底糖尿病溃疡复发率、HbA1c 水平、糖尿病神经病变检查 (DNE) 评分、踝臂指数 (ABI) 和 12 岁和 24 岁内步行速度的影响 周。

方法

我们进行了一项双盲随机临床试验。50 名最近治愈的足底糖尿病足溃疡患者被随机分配到干预组，每周在家中进行 3 次足踝柔韧性和抗阻运动（n  =  25）或对照组（n  =  25）。两组均接受足部护理教育。结果在足底糖尿病溃疡复发或第 12 周和第 24 周时评估，以先到者为准。结果测量包括足底糖尿病溃疡复发、HbA1c 水平的变化、DNE 评分、踝臂指数 ABI 和步行速度。

结果

在 12 周内，12 周内溃疡复发的组间存在显着差异 （干预 8%，对照 68%，RR 0.288；95% CI 0.156–0.534，P  =  0.000） 。

或 24 周（干预 16%，对照 72%，RR 0.222；95% CI 0.088–0.564，P  =  0.000）。DNE 评分增量 (P  =  0.000) 和步行速度增量 (P  =  0.000) 存在显着差异，但在 12 周或 24 周时，各组之间的 HbA1c 增量和 ABI 增量没有显着差异。

结论

足踝柔韧性和抗阻训练可以降低足底糖尿病溃疡的复发率，改善糖尿病神经病变和步行速度。

临床试验编号：NCT04624516